THE ROLE OF CASE MANAGEMENT AND ITS IMPACT

By Judi Williams - Pro Active Case Management Services

| Date: 03/01/2005

A physician once said to me, “If a physician is smart, he will know that a Case Manager is his best friend.” What did this physician know and understand about case management? Case Management is a relatively new discipline in nursing and is now being recognized for its importance as a valuable tool in the worker’s compensation claim. Some continue to misunderstand the role of the case manager and how their involvement impacts a file. Case Management historically was used for catastrophic cases, but as the impact on these cases was clearly seen, more and more it was learned that it could impact those less than catastrophic cases.

It is important to understand that the role of an effective Case Manager is not just to observe, record and report information. The Case Manager actively assesses and interprets the medical information for factors that have implications for the file. They look at all aspects of the file including medical, vocational, psychosocial, and situational factors that can affect the rehabilitation of the injured employee.

Case Managers are educators and motivators working constantly with the injured employee to educate them on their medical condition, treatment and what to expect. We spend so much time with the injured worker during physician appointments that we learn a wealth of information on their condition and perspective. We educate them on what is important to relay to their physician. By assuring they are educated on their condition and by motivating them in their recovery, they show an improved compliance and attitude with treatment and the worker’s compensation process, therefore, ultimately a more prompt closure and more optimal outcome to their injury. More.......